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U Gieler

Publications and source records attributed to U Gieler.

48 records · Page 3Linked to original sources

[The psychosocial status of patients with endogenous eczema. A study using cluster analysis for the correlation of psychological factors with somatic findings].

The present study was performed to investigate whether patients with atopic dermatitis differ as a group from controls on psychological measures of mood and personality or whether psychologically deviant and normal patient subgroups can be distinguished. Furthermore, we were interested in what clinical characteristics might co-vary with psychological disability in patients with atopic dermatitis. In all, 93 patients filled in a standardized mood scale (Hamburg-Erlanger-Stimmungsbarometer) and a personality scale (Kurztest zur Erfassung der Persönlichkeitsstruktur). Compared with matched controls, patients described themselves as being more anxious, more aroused, more depressed and less energetic, and they reached higher neuroticism scores. A cluster analysis identified four patient subgroups. Only one of the subgroups (n = 17) was psychologically disabled according to the questionnaire scores. In contrast to a psychologically stabile patient group, the psychologically disabled patients showed an earlier age of onset of dermatitis, but less intense itching and scratching. They reported more somatic complaints and a higher level of familial stress, were more dissatisfied with their life situation and work, had fewer friends and experienced more losses of significant others. Furthermore, they more frequently rated their disorder as being determined by psychological factors and were more intelligent. Thus, the questionnaires identified a subgroup of patients who may need psychotherapeutic interventions.

Adolescent↗

[Concomitant psoriasis vulgaris and atopic dermatitis. A study of 1,065 patients with psoriasis].

The simultaneous presence of psoriasis and atopic dermatitis was checked for in 1065 patients with psoriasis and was found in 18 of them (1.7%), which is in keeping with the statistical probability. In these 18 the efflorescence was also examined histologically. All 18 (100%) reported marked pruritus; white dermatographism was observed in 16 patients (89%); in 15 patients (83%) psoriatic phenomenas could be produced, and 11 patients (61%) also had allergic rhinitis or bronchial asthma. Immunologically, 16 of the 18 patients (89%) showed elevated IgE levels, the geometric mean level being 888 IU/ml. The HLA-Cw6 was positive in 9 patients (50%).

Adult↗

[Cutaneous artefacts--possibilities for treatment and their limits].

Factitious disorders (FD) of the skin are emergency calls of the patient, whose psychological problems are mostly unconscious. The therapeutic approach is difficult, because the patient does not accept the necessary psychiatric or psychotherapeutic therapy. Therefore, they remain under the medical care of their dermatologists. We report on the experiences of our psychological team gathered during a clinical study on 16 patients with FD. We distinguish between three types of FD, each implicating a different therapeutic approach: unconscious FD (type A), conscious FD (type B), and so-called neurotic excoriations (type C). On the basis of 3 corresponding cases, we discuss the possible psychosomatic therapeutic approaches, the indications and limits of the treatment, as well as prognostic aspects.

Adult↗

["My scale armor protects me"! The personality image and physical disability of psoriasis patients].

With the help of the Giessen-test and the Giessen-complaint form, 28 patients suffering from psoriasis were analysed regarding their personality image and physical disabilities. In comparison with controls (n = 1587), psoriasis patients believed themselves to have "negative social appeal" (p less than or equal to 0.05) and being "reserved" (p less than or equal to 0.01); however, they complained of less physical troubles than healthy controls or psychosomatic patients (p less than or equal to 0.01). Evaluation of these items pointed to depth psychological conflicts of the "not accepted body image" kind, which may precede the disease; the scales might serve as a barrier to psychological troubles.

Adult↗

[The concept of disease in patients with atopic dermatitis].

34 former patients of a dermatological department with atopic dermatitis were compared with 29 patients of an Ear-Nose-Throat-department having similar age, sex and occupation and showing hardly any psychosomatic disturbances. Contrary to our expectations, the empiric-psychological examination did not reveal any impairment of the social behavior or the emotional competence of patients suffering from atopic dermatitis. In comparison to the control group, the patients of the dermatological department attached significantly greater importance to psychological influences on development as well as treatment of the disease. There was a correlation between symptoms "coming from outside" and the social competence; however, this correlation was not significantly greater than the control group. Our investigations suggest that atopic dermatitis may be differentiated into somatical-organizing types and rather psychological-organizing types. The second group shows uncertainties with regard to the social competence.

Age Factors↗

[Development of bacterial flora in leg ulcer].

In the present study of the microbiological flora of 284 ulcera crurum we found 452 various bacterial strains. 174 (61.3%) of the 284 ulcera crurum were found in women, 110 (38.7%) in men with a predominance in the age group between 70-79 years. Staphylococcus aureus were the most frequent bacteria, with an isolation rate of 22,4%. Furthermore, gram-negative bacteria like pseudomonas (14.6%), proteus (10.2%) were isolated. Besides these other species of the group of enterobacteriaceae must be taken into consideration--especially Enterobacter and Klebsiella. In comparison to the results of bacterial isolation rates reported in the literature of the last 15 years, it is obvious that staph. aureus is most common in the bacterial invasion of ulcera crurum . An increase of isolation rates of pseudomonas and proteus and other gram-negative germs could not be found during the last 10 years. The variety of bacterial species on leg ulcers and the frequent occurrence of mixed flora give evidence of the importance of microbiological diagnostic and antibacterial therapy.

Adult↗

[Resistance status of germs in general practice (author's transl)].

It was the aim of this study to investigate the resistance status of germs isolated in environmental examinations and to compare them with results from hospitals. - In general practices a higher level of sensitive germs - mostly Staph. aureus - could be found. Besides multi-resistant gramnegative germs were also determined. A spreading of these resistant germs from hospital into general practices is possible and should receive more attention in general practice hygiene.

Anti-Bacterial Agents↗

[Hygiene in general practice (author's transl)].

This investigation of the hygienic-microbiological situation in general practices included an analysis of hygienic behaviour by questionnaire, environmental examinations by means of "Rodac"-plates and swabs and an efficiency control of sterilising apparatus with spore strips.--It was the aim of the study to find out the present hygineic standards in general practices and to obtain indicatios of possible weak points.--In spite of lacking hygienic consciousness and the mostly insufficient use of disinfectants, the level of contamination of the microbiological environment does not exceed that known from hospitals. Pathogenic staphylococci are demonstrated most frequently and, besides Candida spec., are of special importance. Gram-negative germs, most frequently P. aeruginosa, could be demonstrated but appear comparatively less often. The contamination of hands, common towels, sphygmomanometer cuffs and floors which is well known from hospitals could be confirmed in the general practice. Stethoscopes, soap cakes and journals were, however, less contaminated. Among 103 examined hot air sterilisers 15% failed and in 24% of the cases they were incorrectly operated.--Suggestions for the improvement of practice hygiene are given.

Bacteria↗

Aggressive verbal behaviour as a function of experimentally induced anger in persons with psoriasis.

The importance of psychosocial factors on the etiology and fluctuating disease activity of psoriasis has been discussed in recent years. The present experiment investigated whether psoriatics in an anger-inducing situation show less aggressive verbal behaviour than average person. Twenty-six psoriatics and 26 matched healthy controls were randomly assigned to either an anger-inducing or a non-anger-inducing social situation. The experimental conditions were arranged so that the persons were confronted with either negative, derogatory, or positive, favorable feedback on eight characteristics (intelligence, appearance, maturity, tolerance, honesty, friendliness, humor, and helpfulness). Standardized feedback was given by a confederate of the experimenter. Immediately after the feedback was received by the subjects the photo hand test (PHT) was applied. The PHT is an item-analyzed, validated projective test for aggression. Two independent raters categorized the subjects' responses into six mutually exclusive categories, including a category for responses with aggressive content. 2 x 2 analysis of variance (psoriatics vs controls; anger-induced vs non-anger induced) were calculated for the aggressive responses and the acting-out score (AOS). The results showed a significant interaction, suggesting that psoriatics did indeed exhibit fewer verbal aggression responses under anger-inducing circumstances than the controls.

Adult↗

Clinical pictures and classification of somatoform disorders in dermatology.

Somatoform disorders in dermatology are a heterogeneous group from a biopsychosocial point of view. Among the clinical patterns we find, for example, pruritus, pain, paresthesia as well as feelings of disfiguration, eco-syndromes, erythrophobia or psychogenic pseudoeffluvium. The multiple clinical symptoms are usually accompanied by psychosocial disorders, these are subjective complaints by the patient which cannot be medically objectified. The relevant somatoform disorders in dermatology can be differentiated as somatisation disorders, hypochondriacal disorders, somatoform autonomous disorders, persistent somatoform pain disorders and "other somatoform disorders". A precise differential-diagnostic division is necessary in order to initiate adequate therapy strategies. With this overview article, we would like to make an updated classification recommendation for dermatology and present experiences in therapy.

Humans↗